I know we are not suppose to discuss levels so maybe I can safely phrase it this way. How would 2 mg a day from patches compare in effectiveness to 2 mg a day from pills?

I changed a month ago from patches to pills & I just do not feel as good or the same. A new blood test is around $500 so I'd prefer not to do that all the time.

Thanks for any advise.

You could have a look here:
https://www.susans.org/forums/index.php/topic,190982.msg1703299.html#msg1703299


hugs

After recently being changed from pills to patches, I can say that, for me, patches appear to be doing better.. My level is a touch higher and I, overall, feel better and have had some further breast development - something that stalled about 2.5-3 years ago on pills.

Quote from: Laura_7 on July 12, 2015, 05:41:47 PM
You could have a look here:
https://www.susans.org/forums/index.php/topic,190982.msg1703299.html#msg1703299


hugs

Thanks but nothing there but talk. I know patches deliever drugs better than pills. I just wondered how much of a difference. Like pills are 90% as effective or 50% as effective??? No big deal, I'll ask my doc later. 

I started with pills almost 20 yrs. ago. (stopped after 5 yrs. due to life's issues) They worked fine no side effects reasonable success.  I am now in my late 60's and started 'mones again for the long haul.  This time with patches. Pills are not absorbed directly into the bloodstream and after passing through the digestive system lose some of their efficacy.  Patches are the recommended method of delivery for us older gals, as they do not put any added stress on the liver & kidneys. For some, they can be a skin irritant. The adhesive can fail at times when showering or bathing and they require careful placement (which comes with experience). Also, if you are working out, excessive sweating can be an issue.  Always keep extras on hand just in case you need to replace one before its time to change it.  Hope this helps.
Hugz,
Joi

Quote from: FrancisAnn on July 12, 2015, 07:08:37 PM
Thanks but nothing there but talk. I know patches deliever drugs better than pills. I just wondered how much of a difference. Like pills are 90% as effective or 50% as effective??? No big deal, I'll ask my doc later.

Based on levels, I'd say that patches are about 25% more effective for me - assuming the same dose, which they aren't. Patches have a lower dose and give me a higher serum estrogen level..

Which method is most effective varies by person.

However, a 0.1 mg patch (that is, 1/10th of a milligram) is roughly equivalent in terms of average blood estrogen levels achieved to 2 mg of estrogen. Which means, if my math is correct, that a patch delivers about the same punch per milligram as 20 1 mg pills. That's not the same as saying it's 20X more *effective* in terms of feminization, though, because the patch doses are titrated for that effectiveness - a fancy way of saying that doctors prescribe patches in tenths of mg and pills in whole mg. They don't prescribe 2 mg per day in patches, as that would be 20 freaking patches.

(THIS IS NOT DOSAGE ADVICE. These numbers are included for illustration only, using one of several commonly found patch dosages, and is not a recommendation of any kind.)

Thanks Jenna Marie for clarifying that difference between the 0.1 mg. patch & the 1 mg. pill. Helped me understand my patch therapy better.

Quote from: FrancisAnn on July 12, 2015, 07:08:37 PM
Thanks but nothing there but talk. I know patches deliever drugs better than pills. I just wondered how much of a difference. Like pills are 90% as effective or 50% as effective??? No big deal, I'll ask my doc later.

Everyones skin is different. So there is no definite comparison.
Patches deliver a steady dose , usually not that high. Delivery is supposed to be more safe due to delivery into the blood stream which is supposed to be connected with less clotting factors.
With pills there is a slight seesaw pattern, which can be seen in the graphics in the link above.
Sublingual use instead of directly swallowing is also supposed to avoid some strain on the liver and some clotting factors, and its supposed to be a bit more effective. All shown in the graphics above.
To keep levels more steady spreading the daily dose over lower doses a few times a day instead of one or two higher doses might help.
The seesaw pattern might affect mood, like a slight pms syndrome a few times a day. As said, spreading the dose for more steady levels might help.

Concerning levels, many docs meanwhile not only look at levels but ask how the patient feels.

If you feel your levels are lower you might talk to your doc.

Quote
Which means, if my math is correct, that a patch delivers about the same punch per milligram as 20 1 mg pills.

You mean 2  1mg pills.
All in theory because it depends on the individual skin, absorption can be different from individual to individual.

You might think about adding bioidentical progesterone, which also might help with mood, even out some side effects of estro and might help with breast development.

hugs

I've found patches to be much better as a hormone delivery system as I had to change over to them from pills due to health problems. My breasts woke up and grew a bit more, my skin is nicer and no issues with GI side effects. The only downside to patches is trying to find the best way to get the left behind black circles off my skin whenever I remove one.

THanks so much. I used patches for about a year with not too much irriation however I started to itch so much it drove me crazy so a month or so I switched back to pills. I know patches are safer & seem more effective so maybe I'll try again soon. 7 larger days patches were easy if they did not itch so much. I could only stand them for 2-3 days then a red rash. I have sensitive skin. Other 3.5 day smaller patches worked OK but such a pain changing every 3 & 1/2 days but they might be the best solution & safer. Maybe I should ask my doc more about a pellet implant. That might be the best solution.  Thanks so much & good luck to us all.

I've been on & off E since my early 20's. I tried hard to correct my gender long ago but I had to stop. Now in my late 50's, in good health & look very good. I started back full time with pills 2 years ago then changed to patches to try & be safer. I want a nice long life. I take care of myself, eat right, on the Atkins diet for 6 months, MBI of 26.5. I look good after all my plastic surgery. Anyway I stiched to patches about a year ago with little 3.5 day patches & they did not itch too much, then tried the climara 7 days patches & they worked OK for a while then itched so much I would have to take them off in 2-3 days, such a waste of money. So now back to pills. Ugggg, so frustrated. I want to live long & be safe so maybe I'll try patches again. Maybe an implant is right but I hear a lot of bad stories about pellet implants. I do not need more trouble. I've had a plenty healing up from surgeries.

Oh me, it's so frustrating if only some safe simple way to receive the right hormone. Good luck to us all.

Laura : No,  I mean 20. I referred to 1/10th milligram patch. So 1 mg of patch is 10x as much as a tenth of a mg, meaning the 2 mg pill dose also would get multiplied by 10 = 20. There actually are studies out there making the comparison in average blood levels, as well.  I actually picked 0.1 mg just to make the math easier for me!

Joi : Glad to help.

Haven't had pills, but patches were fine. Never experienced the roller coaster of emotions that some people on pills describe, and had very good breast growth.

Oh, yeah, patches are annoying in a practical sense. I rotated patch locations, but they still left my skin with minor irritation and itching. I do have pale, sensitive skin, though. I burn easily and glow in the dark... @_@

I'm going to rotate locations more. That might have caused the problem, I kinda used the same areas over & over. 7 day patches were nice, kinda forget them. Thanks.

If I remember correctly, you are supposed to rotate locations because each location can become irritated from the adhesive and not absorb it as well as a result.
Mariah

Quote from: FrancisAnn on July 13, 2015, 06:12:28 AM
I'm going to rotate locations more. That might have caused the problem, I kinda used the same areas over & over. 7 day patches were nice, kinda forget them. Thanks.

I so wish there were some better way. I see my doc Thursday. I'm going to ask about implants again. I do not want to go through life dealing with patches or pills if I can help it. Patches gave me fits itching, red areas, know pills are not safe in the long run. Yuck. Good luck to us all.

My completion has surely changed in the past few weeks, ugggg. I'm gonna stick a patch on my butt & hope for the best. I just cannot take life without estrogen. Thanks to all.

The patches can be extremely effective.  However, for some like me, I was sensitive to the adhesive and had to change.  Pills were not an option due to metabolism difficulties.  That left shots or cream.  I use the cream.  I use a low dose twice a day with no real problems and it is very effective.  I have not tried shots.

There are companies in the US that will do estrogen testing on-demand.  It's $150.00 US and was cheaper than the lab that my doctor was sending me to use. 

Hugs,

Jen

Patches never worked for me, irritation and loss of adhesion 
Went on Oral... next stop implants/pellets

Katy xx